Now that the United States Presidential election is over and the Supreme Court ruled that the Affordable Care Act (ACA), also known as Obamacare, is indeed constitutional, the focus has shifted to the implementation of ACA. The law is very favorable toward the treatment of mental illness, increasing the access to mental health care and providing parity of coverage for the treatment of mental illness compared to other illnesses. There are other aspects of the bill that are more problematic and APA and AMA are working to change those provisions.

In Zone 2, there were two major AmericanPsychiatric Association (APA) meetings in2012: the annual meeting in Philadelphia in May and the Institute on Psychiatric Services in New York City in October. The annual meeting had approximately 11,000 attendees, including 2,900 international attendees from92 countries. There were a number of international symposia and special presentations and a meeting of the leadership of APA and WPA. The Institute on Psychiatric Services is an annual smaller meeting in October each year with a special focus on systems of care and public health issues. At this past October meeting, WPA President Professor Pedro Ruiz, received the APA Administrative Psychiatry Award (for the 2nd time in his illustrious career) and delivered a lecture entitled “Poverty as a Factor in Social Crisis and Human Disasters”. At APA, we have raised the issue of the possibility of an APA meeting being co-sponsored by WPA, perhaps a future Institute on Psychiatric Services. This will be further discussed at the Board of Trustees meeting in March.

A major APA focus at this time is the final work on DSM 5 which will be published and released at the annual meeting in San Francisco in May, 2013, 19 years after the publication of DSM IV. Several dozen international colleagues have had major roles in the development of this manual and there has been considerable effort to harmonize the DSM 5 and ICD 11. There are many notable changes in DSM 5 including the elimination of the multi-axial system. Five categories that will undergo major changes in the DSM 5 are Autism Spectrum Disorders, Substance Use Disorders, Eating Disorders, Sleep Disorders and Neurocognitive Disorders.